Temporal Change in Blood Group after Bone Marrow Transplant: A Case of Successful ABO-Incompatible Deceased Donor Transplant

ABO-incompatible kidney transplantation has been successfully utilised in a deceased donor and living donor kidney transplantation to improve organ utilisation and decrease waiting times. We describe a case of a successful, unanticipated ABO-incompatible donation after cardiac death (DCD) kidney tra...

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Bibliographic Details
Published in:Case reports in transplantation 2020-01, Vol.2020 (2020), p.1-4
Main Authors: Campbell, Scott, Preston, John, Hultin, Sebastian, Lam, Susanna
Format: Article
Language:English
Subjects:
Antibodies
B cells
Basiliximab
Blood groups
Blood tests
Blood transfusions
Bone marrow
Cardiac arrhythmia
Case Report
Case reports
Creatinine
Donation of organs, tissues, etc
Hematology
Hematopoietic stem cells
Hemodialysis
Hemoglobin
Immunotherapy
Kidney transplants
Kidneys
Patients
Potassium
Stem cell transplantation
Stem cells
Tazobactam
Transplantation
Type 2 diabetes
Valganciclovir
Viral antibodies
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Summary:ABO-incompatible kidney transplantation has been successfully utilised in a deceased donor and living donor kidney transplantation to improve organ utilisation and decrease waiting times. We describe a case of a successful, unanticipated ABO-incompatible donation after cardiac death (DCD) kidney transplant in a patient who had a previous ABOi haematopoietic stem cell transplant (HSCT) and had reverted to his original blood group B, after matching as a blood group A recipient with a blood group A donor. The recipient was unsensitized with a cPRA which was 0% and no donor-specific antibodies and zero HLA mismatch. An urgent anti-A titre was 1 : 2. Given the low antibody titres, we proceeded to transplantation. The patient developed delayed graft function and required dialysis on postoperative day 1 and day 2. The creatinine fell spontaneously on day 5, with progressively increased urine output and stable graft function on discharge at day 6. Anti-A titres were 1 : 1 on serial postoperative measurements. There were no rejection episodes, and the patient has a functioning graft at 16 months posttransplant. We describe a rare case in which the blood group can change after stem cell transplant and should be checked. We also demonstrate that a DCD ABOi transplant in the context of low anti-A titres for a patient with previous ABOi stem cell transplant can be performed successfully with standard immunosuppression.
ISSN:2090-6943
2090-6951
DOI:10.1155/2020/7461052